Description of private practitioners reaction to managed care

This study investigated the impact of managed care protocols on private practitioners and agency-base social workers. Social workers self-perceptions of likely practice behavior were considered and were measured on the following: accurate reporting, confidentiality, terminating/and or curtailing services that are needed and providing the services the client's condition warrants. A sample of 89 social workers obtained from the panel of local managed care companies was used and responses were aggregated to distinguish those that were exclusively private practitioners from agency practitioners. Respondents were asked to complete a survey pertaining to specific practice situations and to rate the frequency of each situation as it may occur. The situations were based on practice setting, social work conflict, and a common part of social work. As a result of disparity between the private practitioners (n=71) and agency base social workers (n=16) the groups were not compared and findings were discussed separately. Results showed that over half of the respondents reported a conflict in providing diagnoses for reimbursement, maintaining confidentiality, terminating treatment, and complying with adverse decisions; and the majority reported that it is a common part of social work practice. These findings have important implications for contemporary social work practice and identify the issues that social workers are experiencing such as financial pressures and significant frustration with the managed care system. This study may assist in offering recommendations to managed care organizations in revising their policies and procedures that may be more amenable to the needs of clinicians and clients